The purpose of this proposal for a "Mid-career Investigator Award in Patient-Oriented Research" is to support development of advanced expertise in interventions and services research focusing on older persons with severe mental illness (SMI). These efforts respond to the need to develop rehabilitative interventions and services that enhance independent functioning and health care management, and to evaluate use and costs of services. The four goals of this mid-career development proposal are: (1) to develop and evaluate models of rehabilitation and health care management for older adults with SMI; (2) to evaluate use, costs, and outcomes of services for older adults with SMI; (3) to expand current research efforts to include more culturally diverse settings; and (4) to enhance mentored research opportunities in geriatric mental health services research for early career investigators. This award will address these goals through an integrated career development plan, research plan, and mentoring plan. The Career Development Plan for this award develops advanced research skills for the candidate through collaborations with experts in aging and SMI, rehabilitation, functional assessment, integration of primary care and mental health care, and cost analysis. The Research Plan includes detailed descriptions of several studies focusing on older adults with SMI including a 5-year, randomized trial of a rehabilitation and health management intervention; a pilot study of a vocational rehabilitation intervention; and a study of the health care costs associated with SMI, aging, and medical comorbidity. In addition, a series of pilot studies are briefly described that will be conducted over the 5-year term of the award to inform future randomized trials. The Mentoring Plan for this award describes how these studies will provide mentored research opportunities for early career investigators. Finally, a program of supervision and training is outlined to support the development of future researchers in the field of geriatric intervention and services research.